Payroll Title:
CASE MGR EX CEH Department:
PHSO - CLINICAL OPERATIONS Hiring Pay Scale
$161,172 - $212,558 / Year Worksite:
La Jolla Appointment Type:
Career Appointment Percent:
100% Union:
HX Contract Total Openings:
1 Work Schedule:
Days, 8-Hour Shift, Monday-Friday
#141189 (RN) Prior Authorization UM Case Manager - HybridFiling Deadline: Wed 9/30/2026 Apply Now
This position may work a hybrid schedule, which includes a combination of working both onsite at Greenwich Drive and remote. Current department requirement is on-site one day per week.DESCRIPTIONThe Population Health Care Connections Hub consists of a team of RN with case management experience who perform telephonic outreach to high-risk patients to help prevent avoidable events. Most of these calls are for patients who discharge from an acute inpatient stay and /or it could be for internal provider referrals for our patients who may need additional help while at home. This role requires someone who has strong initiative, critical thinking skills, and previous case management experience. Previous experience with EPIC and Care Port a plus. Knowledge of community resources is critical to help patients with their care coordination needs. A strong understanding of payers, community resources, DME, HH, and skilled nursing facilities in the area is critical to being successful in this role
While not required, a cover letter is highly recommended when applying to this position.MINIMUM QUALIFICATIONS- Must be a graduate from an accredited school of Nursing.
- RN license issued by the State of California.
- Minimum two (2) years of recent RN experience in inpatient case management and recent ambulatory RN CM experience.
- Proven background in managing high-risk patients post-discharge. Strong preference for experience in telephonic outreach with high-risk patient populations and working with insurance companies.
- Proficiency in Information Systems and computer programs such as Word and Excel.
- Must possess excellent interpersonal and communication skills.
- Must be able to work within a team environment.
PREFERRED QUALIFICATIONS- BSN or Master's Degree.
- ACM and/or CCM certificate.
- Epic knowledge and experience.
SPECIAL CONDITIONS- Must have access to high-speed internet when working remotely.
- Must be able to work various hours and locations based on business needs.
- Employment is subject to a criminal background check and a pre-employment physical.
Pay Transparency Act
Annual Full Pay Range: $161,173 - $212,558 (will be prorated if the appointment percentage is less than 100%)
Hourly Equivalent: $77.19 - $101.80
Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).
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If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements. If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable. UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and dozens of outpatient clinics. We invite you to join our team!
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